Etna social worker stresses the need for sexual education for people with autism and intellectual disabilities

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One man with an intellectual development disorder, formerly known as mental retardation, was outside when he saw an attractive lady approaching. He put his hands inside his pants to deal with his sexual urges.

He was arrested for public masturbation for the second time and now has spent four years in prison. 

Another young man, this one with autism, was masturbating inside his rural house. The window blinds were open. Unfortunately, a school bus drove by, leaving him in full view of the children on the bus. He, too, was arrested, convicted and jailed on multiple counts of exposing himself to children.

Such problems can occur, often unwittingly, to people with autism spectrum disorder or intellectual development disorder. The children typically have normal hormonal development with sexual feelings and function. But they also can be unaware of their surroundings or social standards when deciding to satisfy sexual desires.

Sexual activity among those with such disorders “is a huge issue that is often overlooked by parents and others,” said Shawn McGill of MSW Consulting Inc. in Etna. “Prison is not the place for our guys to go.”

With a master’s degree in social work, Ms. McGill trains teenagers and men with autism spectrum and intellectual development disorders who’ve been arrested or jailed for sex crimes ranging from exposure or public masturbation to rape. She works to help them develop social awareness, keep their sexual activity private and abide by social norms.

Her other role involves educating parents and social service professionals about the importance of educating such children to limit sexual activities to their bedrooms while controlling sexual desires in public. Parents must be ready to address such issues directly as the child enters puberty. No blushing is necessary in clearly explaining the mechanics of sex and proper sexual behavior.

Recently Ms. McGill presented the topic at Aboard’s Autism Connection of PA, an Etna support group for parents of children with autism, with more than 50 people in attendance, including parents, social service professionals and even people with autism interested in gaining knowledge about the topic. She gave another presentation last week in Butler.

Shawn’s topic is important because social skills can be difficult for many people with autism, yet they can develop individual relationships with encouragement and some structure,” said Luciana Randall, executive director of Aboard. “Caregivers need to get comfortable discussing health and sexuality issues with the assumption that young people will want and can have positive romantic relationships.”

Expecting people with autism to absorb requisite information about the dating culture is like expecting a person without autism “to absorb something like calculus,” Ms. Randall said.

“Both are complex topics and require direct teaching, discussion with an adult in a leadership role, and practice,” she said. “That's what people like Shawn are good at, helping the rest of us understand. If we take time to listen and help, we can improve the quality of life for people with autism in age-appropriate relationships they deserve.”

Most parents dread the task of teaching the birds-and-bees to their pubescent children. Adding autism to the mix makes the task not only more difficult and time-consuming but also more imperative. 

“For guys, the lack of opportunity for a safe course of sexual expression is lacking,” Ms. McGill said. “People aren’t talking about it or writing about it. My hope is for parents to get involved in talking about this to prevent problems on the front end and prevent boys from ending up in the legal system or challenging people in social services. 

“This is hard stuff and that’s why we’re talking about it,” she said. “You need guidelines and tools to address this.”

Parents, she said, should neither overreact nor underreact when the child with autism or intellectual disability is caught masturbating or engaging in sexual behavior at home. But if the parent hasn’t begun educating the child about sex, the time has arrived.

She advises parents to instruct the child that “whatever part of your body that is covered by a bathing suit is a private part. If you want to touch it, you have to go to your bedroom.”

"You need to have these conversation or it can get bad,“ she said, recommending straightforward, clear language.

Autism involves neurological problems in the brain, leading to deficits in general intellectual functioning in terms of judgment, reasoning, planning, abstract thinking, educational  learning and learning from experience.

Understanding the social context of their behaviors can pose major problems because there’s little awareness or concern that people are watching.

IDD, also a neurological developmental disorder with attendant intellectual challenges, also can have an impact of sexual awareness.

As the child approaches dating age, Ms. McGill said, parents should teach hygiene and necessary social skills to develop relationships with people. That includes teaching them to refrain from socially unacceptable public behaviors such as burping and passing gas, among others.

“You have to back it down into more concrete terms, black and white, because they have problems in the gray area,” Ms. McGill said.

She begins her talk with a request for the audience to suspend moral and religious attitudes and focus on the course of sexual development that people naturally experience, including those with autism or intellectual development disorder.

“Their hormones are fine, and they arrive on time and are never delayed,” she said to the audience. “Early puberty seems to occur more often for individuals with ASD and IDD.”

But don’t panic when a child’s body begins changing with attendant mood swings. Boys can begin having dreams involving sexual climax while menstruation begins with girls. Boys and girls alike, but primarily boys, begin masturbating and engaging in sexual fantasizing. 

So she advises parents to establish one clear rule: Sexual behavior occurs in one’s bedroom with the door closed. No sexual behavior can occur in public places, including public rooms in the house. Yes, boys can look at girls and women but for no more than the three Mississippi’s.  

In such cases, parents overreact to pubescent behavior, sometimes to the detriment of the child, Ms. McGill said, noting cases she’s been involved with.

One boy with autism began masturbating openly, prompting the embarrassed mother to scold him that if he continued touching himself, his penis would fall off. The boy grew so fearful about touching himself that he began using pencils, wires and other instruments to help him urinate, leading to serious genital injuries.

Another mother grew so upset about her son masturbating that she made the boy, who had autism, wear a tight wrestling suit backward with a belt around his waist and buckled in the back. The attempt to prevent masturbation prompted the sexually frustrated boy to begin beating his mother. 

“You have a choice,” Ms. McGill said she told the mother, “him alone in his bedroom or you in the hospital.”

In public, boys with autism can be prone to walking around with erections, staring at women’s chests, rubbing against people or improperly touching other people. Some become obsessed with pornography or begin stalking girls whom they mistakenly think are interested in them. 

And while the bathroom is a private place, parents must make it clear it is no place for sexual activity. It might lead to masturbation in public restrooms, putting them at risk to be arrested.   

Boys with autism also should be blocked from Internet pornography to prevent obsessive behavior. But Ms. McGill does suggest that parents provide boys with a girlie magazine for use exclusively in the bedroom. The idea can raise controversy, she acknowledges, but it’s preferable to the boy engaging in improper public behavior to satisfy his desires.

Parents reacted strongly but positively to the comprehensive, step-by-step strategy Ms. McGill provided in her presentation.

During one break, the father of a 13-year-old boy, who said he’d provided no sex education to son with autism, told the person next to him, “This actually is scaring the hell out of me.” 

But Kristin, 34, of Hampton, who has a 7-year-old son with autism, said Ms. McGill’s presentation excellently broke down each stage of sexual development, with guidance and tools for the parent about dealing with each issue.

“I almost feel better about it now,” she said, preferring not to provide her last name. “I was concerned before I came here. But as long as you communicate and have the ability to talk about it, you can help your child. It helped calm me for the future.”

M.J. Crane of Sewickley, whose 15-year-old son has autism, also said Ms. McGill’s recommendations were extremely helpful.

“I learned that I still have teaching to do with my son,”“ she said.


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